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The role of cytokine profile and lymphocyte subsets in the severity of coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis.
Life Sci. 2020 Oct 01; 258:118167.LS

Abstract

AIMS

This study aimed to make a comparison between the clinical laboratory-related factors, complete blood count (CBC) indices, cytokines, and lymphocyte subsets in order to distinguish severe coronavirus disease 2019 (COVID-19) cases from the non-severe ones.

MATERIALS AND METHODS

Relevant studies were searched in PubMed, Embase, Scopus, and Web of Science databases until March 31, 2020. Cochrane's Q test and the I2 statistic were used to determine heterogeneity. We used the random-effect models to pool the weighted mean differences (WMDs) and 95% confidence intervals (CIs).

KEY FINDINGS

Out of a total of 8557 initial records, 44 articles (50 studies) with 7865 patients (ranging from 13 to 1582), were included. Our meta-analyses with random-effect models showed a significant decrease in lymphocytes, monocyte, CD4+ T cells, CD8+ T cells, CD3 cells, CD19 cells, and natural killer (NK) cells and an increase in the white blood cell (WBC), neutrophils, neutrophil to lymphocyte ratio (NLR), C-reactive protein (CRP)/hs-CRP, erythrocyte sedimentation rate (ESR), ferritin, procalcitonin (PCT), and serum amyloid A (SAA), interleukin-2 (IL-2), IL-2R, IL-4, IL-6, IL-8, IL-10, tumor necrosis factor-alpha (TNF-α), and interferon-gamma (INF-γ) in the severe group compared to the non-severe group. However, no significant differences were found in IL-1β, IL-17, and CD4/CD8 T cell ratio between the two groups.

SIGNIFICANCE

Decrease in total lymphocytes and lymphocyte subsets as well as the elevation of CRP, ESR, SAA, PCT, ferritin, and cytokines, but not IL-1β and IL-17, were closely associated with COVID-19 severity, implying reliable indicators of severe COVID-19.

Authors+Show Affiliations

Department of Biochemistry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran; Student Research Committee, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran; Bioinformatics and Computational Biology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.Biochemistry Department, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.Department of Medical Laboratory Sciences, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.Department of Biochemistry, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran.Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.Student Research Committee, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran. Electronic address: sanaz.faramarz68@gmail.com.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

32735885

Citation

Akbari, Hamed, et al. "The Role of Cytokine Profile and Lymphocyte Subsets in the Severity of Coronavirus Disease 2019 (COVID-19): a Systematic Review and Meta-analysis." Life Sciences, vol. 258, 2020, p. 118167.
Akbari H, Tabrizi R, Lankarani KB, et al. The role of cytokine profile and lymphocyte subsets in the severity of coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis. Life Sci. 2020;258:118167.
Akbari, H., Tabrizi, R., Lankarani, K. B., Aria, H., Vakili, S., Asadian, F., Noroozi, S., Keshavarz, P., & Faramarz, S. (2020). The role of cytokine profile and lymphocyte subsets in the severity of coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis. Life Sciences, 258, 118167. https://doi.org/10.1016/j.lfs.2020.118167
Akbari H, et al. The Role of Cytokine Profile and Lymphocyte Subsets in the Severity of Coronavirus Disease 2019 (COVID-19): a Systematic Review and Meta-analysis. Life Sci. 2020 Oct 1;258:118167. PubMed PMID: 32735885.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The role of cytokine profile and lymphocyte subsets in the severity of coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis. AU - Akbari,Hamed, AU - Tabrizi,Reza, AU - Lankarani,Kamran B, AU - Aria,Hamid, AU - Vakili,Sina, AU - Asadian,Fatemeh, AU - Noroozi,Saam, AU - Keshavarz,Pedram, AU - Faramarz,Sanaz, Y1 - 2020/07/29/ PY - 2020/06/23/received PY - 2020/07/18/revised PY - 2020/07/25/accepted PY - 2020/8/1/pubmed PY - 2020/9/30/medline PY - 2020/8/1/entrez KW - COVID-19 KW - Cytokine KW - Laboratory findings KW - Lymphocyte subsets KW - Meta-analysis KW - Novel coronavirus KW - SARS-CoV-2 SP - 118167 EP - 118167 JF - Life sciences JO - Life Sci VL - 258 N2 - AIMS: This study aimed to make a comparison between the clinical laboratory-related factors, complete blood count (CBC) indices, cytokines, and lymphocyte subsets in order to distinguish severe coronavirus disease 2019 (COVID-19) cases from the non-severe ones. MATERIALS AND METHODS: Relevant studies were searched in PubMed, Embase, Scopus, and Web of Science databases until March 31, 2020. Cochrane's Q test and the I2 statistic were used to determine heterogeneity. We used the random-effect models to pool the weighted mean differences (WMDs) and 95% confidence intervals (CIs). KEY FINDINGS: Out of a total of 8557 initial records, 44 articles (50 studies) with 7865 patients (ranging from 13 to 1582), were included. Our meta-analyses with random-effect models showed a significant decrease in lymphocytes, monocyte, CD4+ T cells, CD8+ T cells, CD3 cells, CD19 cells, and natural killer (NK) cells and an increase in the white blood cell (WBC), neutrophils, neutrophil to lymphocyte ratio (NLR), C-reactive protein (CRP)/hs-CRP, erythrocyte sedimentation rate (ESR), ferritin, procalcitonin (PCT), and serum amyloid A (SAA), interleukin-2 (IL-2), IL-2R, IL-4, IL-6, IL-8, IL-10, tumor necrosis factor-alpha (TNF-α), and interferon-gamma (INF-γ) in the severe group compared to the non-severe group. However, no significant differences were found in IL-1β, IL-17, and CD4/CD8 T cell ratio between the two groups. SIGNIFICANCE: Decrease in total lymphocytes and lymphocyte subsets as well as the elevation of CRP, ESR, SAA, PCT, ferritin, and cytokines, but not IL-1β and IL-17, were closely associated with COVID-19 severity, implying reliable indicators of severe COVID-19. SN - 1879-0631 UR - https://www.unboundmedicine.com/medline/citation/32735885/The_role_of_cytokine_profile_and_lymphocyte_subsets_in_the_severity_of_coronavirus_disease_2019__COVID_19_:_A_systematic_review_and_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0024-3205(20)30919-X DB - PRIME DP - Unbound Medicine ER -